No Signatures Required!

By Kim Bellard, April 18, 2018 If you live in the U.S., you've probably had the experience of paying for a meal using a credit card.  The server takes your card, disappears to somewhere in the back, does something with it that you can't see, and returns with your card, along with two paper receipts, one of which you need to sign. As of last week, the major credit card companies are no longer requiring that signature.  As a Mastercard person told CNET, "It is the right time to eliminate an antiquated practice."   No kidding.  Healthcare should be eliminating its antiquated practices too. Ending the requirement was announced last year, went away last week, but its actual demise will happen more slowly, as individual merchants can still require it.  Of course, the signature is only part of the antiquated process.  They're probably not looking up your card number on a monthly list of stolen cards any longer, nor using a manual imprinter to charge your card, but both using the physical card and taking it from you are steps that there are 21st century alternatives to.  Still, I'd be willing to bet that the credit card companies and merchants bring their processes fully into the 21st century before healthcare does. Let's go through some of these: ·         Healthcare still relies heavily on faxes. Supposedly it is because of security, "HIPAA," etc., but this reliance is a lot like requiring signatures for credit cards.  ·         In an era of ubiquitous smartphones, healthcare is still making heavy use of pagers, especially within hospitals.  ·         I can use an AMT pretty much anywhere in the world, and can not only access my bank account to obtain balance or transfer funds, but even to get cash on the spot.  In healthcare, I can't even go to a new doctor or healthcare facility without having to start from ground zero in terms of information about me (unless they are part of a health system I've already used).   ·         Patient portals have proliferated, with more options to do tasks online, but how many times do you visit a health care professional without having to fill out or sign yet another form?  ·         We can make online reservations for, say, restaurants, airlines, or hotels.  When it comes to making healthcare appointments, though, we're almost always forced to go through a tedious phone tree and end up negotiating with a human scheduler.   In 2018? ·         Manufacturers have overwhelmingly turned to just-in-time processes.  Meanwhile, in healthcare, an appointment time is usually at best an approximation; we expect to be seen late.  If you are in a facility expecting a test or procedure, it's even worse.  These aren't even 1960's levels of precision. ·         Telemedicine is widely available, but usually it won't be with your doctor and the doctor you end up getting won't have your medical history.  Shouldn't virtual visits usually be the first step?   ·         With healthcare there, no institution has access to even most of our medical history, which remains highly scattered, siloed, and sometimes even still paper-based.  How 1980's!   ·         We continue to urge people to get annual preventive exams, even though the value of them for most adults is highly dubious.  We still make people get unpleasant procedures like digital rectal exams, or tests of questionable value like PSAs or even mammograms.   In many ways, we do have "space age" healthcare, but that space age is too often more like 1960's NASA than 21st century SpaceX.  We can do better.  Much of healthcare has one foot firmly planted in the 21st century, and its vision looking forward.  But too much of it still has the other foot dragging in the 20th century. It is past time to not only identify but also to act upon antiquated practices in healthcare.   This post is an abridged version of the posting in Kim Bellard’s blogsite. Click here to read the full posting